Steroid Pulse for IgA Nephropathy Treatment(Merry Christmas in Hospital), Japan, Dec 20-25, 2013

I was hospitalized for kidney treatment from the 20th to 25th of December 2013.
This was next stage treatment after tonsillectomy last October.
This treatment is « Steroid Pulse »: steroid is administered through intravenous drips.

I found some articles about « steroid pulse therapy for kidney » on the Internet.
Those are written in English, however, by Japanese doctors.
I’m not sure whether « steroid pulse therapy for kidney » is developed by Japanese and is permitted in only Japan.
Anyway, those articles are for experts, so I record my experience and knowledge from patient view.

Eligible Person
A patient who has more hematuria and proteinuria, but kidney function works normally by blood samplings, such as « blood urea nitrogen(BUN) », « cleatinine(CREA) » and « Estimated Glomerular Filtration Rate(eGFR) ».
This treatment is especially meaningful for young patients.

Effect
Diminish abnormal « Immunoglobulin A(IgA) » in blood and deposited IgA in kidney.
Suppress inflammation in glomeruli.

Method and Duration

Intake of steroid pulse and pills one after the other for about 1 – 2 years.

No Treatment Detail My Status
1 Steroid Pulse(1st) 500mg steroid is administered through IV at the speed of 1 – 2 hour for 3 days. Done.
2 Steroid Pills(1st) 20 – 30mg steroid pills are took in by mouth every other day until next steroid pulse treatment. Now.
3 Steroid Pulse(2nd) Steroid is administered through IV.
Amount of intake depends on your doctor’s decision.
This second course should be done within one month after first one.
Scheduled.
4 Steroid Pills(2nd) Some steroid pills are took in by mouth until next steroid pulse treatment.
Amount and interval of intake depends on your doctor’s decision.
Not yet
5 Steroid Pulse(3rd) Steroid is administered through IV.
Amount of intake depends on your doctor’s decision.
This third course should be done within 6 months after first one.
Not yet
6 Steroid Pills(3rd) Some steroid pills are took in by mouth.
Amount and interval of intake depends on your doctor’s decision.
Not yet

==================================================================

Here are my life in hospital, Shin-Urayasu Juntendo University Hospital.

Day 0 – Dec 20th(Fri),2013

I checked in hospital around 2:00PM.
After blood sampling, urine sampling, electrocardiogram and X-ray,
I got detail explanation of side effects about this treatment.
These symptoms don’t appear right away, however, it depends on individuals.

  • Common Side Effects
    1. Vulnerable to infectious disease like flu
    2. Hyperlipidemia
    3. Diabetes
    4. Mind Disorder
    5. Osteoporosis
    6. Obese
  • Rare Side Effects
    1. Cataract
    2. Glaucoma – I’ve already suffered from this.
    3. Peptic Ulcer
    4. Edema
    5. Polycythemia
    6. Muscle Loss
    7. Hair Loss

Day 1 – Dec 21th(Sat),2013
8:30AM : These medicines were prescribed.
Livalo for high cholesterol.
Nexium for peptic ulcer.
Edirol for osteoporosis.

9:15AM : Needle was inserted for intravenous drips.
9:30AM – 11:30AM : Steroid Pulse: 500mg Solu-medrol was prescribed.

I felt hot flash and thirsty.

Day 2 – Dec 22th(Sun),2013
8:30AM : The same medicines were prescribed: Livalo, Nexium and Edirol.
9:55AM – 11:55AM : Steroid Pulse: 500mg Solu-medrol was prescribed.

Day 3 – Dec 23rd(Mon),2013
8:30AM : The same medicines were prescribed: Livalo, Nexium and Edirol.
9:55AM – 11:25AM : Steroid Pulse: 500mg Solu-medrol was prescribed.

Day 4 – Dec 24th(Tue),2013
6:00AM : Blood and Urine sampling
8:30AM : The same medicines(Livalo, Nexium, Edirol), plus 20mg prednisolone
12:30PM : 10mg prednisolone

Day 5 – Dec 25th(Wed),2013
I was supposed to be detained in hospital until Dec 26h,
however, fortunately was allowed to leave.

The cost was 73,240 yen.
The total cost of hospitalization in August, October and December is 246,140yen.
It cannot be helped.

==================================================================

Here are my blood and urine sampling records for around one year.

Blood Sampling Urine Sampling
Date BUN CREA eGFR pH SG Protein U TP OB U-Crea RBC WBC Sediment
Aug/7/2012 15 0.88 78 7.5 1.006 (+-) <=20 (3+) 53.6 16-20 1-5 1 hyaline cast
Dec/18/2012 16 0.87 NR 6.5 1.015 30 25H (3+) 118.0 NR NR NR
Apr/9/2013 13 0.84 81 5.5 1.019 100 47H (3+) 243.3 26-30 1-5 1 hyaline cast
2 red blood cell cast
Jun/11/2013 NCW NCW NCW 6.0 1.026 100 79H (3+) 337.3 many 1-5 1 red blood cell cast
3 hyaline fatty cast
2 OFB
Jul 29th – Aug 3rd, 2013
Kidney Biopsy
Aug/27/2013 14 0.85 80 6.0 1.012 30 37H (3+) 115.6 21-25 1-5 3 hyaline cast
1 granular cast
1 red blood cell cast
Aug 27th, 2013
I was diagnosed as IgA Nephropathy.
Nov/5/2013 15 0.83 83 6.5 1.031 300 121H (3+) 346.6 many 1-5 1 epithelial cast
1 granular cast
Dec/20/2013 17 0.99 68 6.5 1.016 100 48H (2+) 156.7 16-20 1-5 3 hyaline cast
Dec 21th-23rd, 2013
Steroid Pulse Treatment(1st)
Dec/24/2013 24H 0.80 86 6.0 1.022 (+-) <=20 (2+) 129.6 6-10 a few 1 hyaline cast

As for me, the key index is « U TP » which means « total protein in urine ».
In case of those whose kidney function works well, « U TP » is under 20.
I got « under 20 » for the first time in one and half year.
This is a blessing.
But, it’s still too early to whoop for joy.
« Occult Blood(OB) » is still (2+), plus everything is thanks to taking in steroid.
Be patient with humble diet. No salty food!!
I’ve been a veggie at home for three years.
But, I’m getting to know it seems I’m likely to develop flu without meat and fish from three years’ experience.
High fever cause proteinuria relapse.
That’s why I’m going to lift no-meat-no-fish policy at home.

===================================================

By the way, we celebrate Christmas Eve rather than Christmas Day in Japan.
I don’t know which is more important for Christians.
I couldn’t get a gorgeous meal this eve of Christmas.
No wonder I was in hospital.
But, I saw the menu on board which told there was a special dessert for dinner.
I wondered what’s that all day.
Here it is!!

See left top!! Powdered starch jelly!! It’s the same as usual.
This hospital serves a powdered starch jelly to those who have kidney problems every night.
This is my destiny.

Instead of a Christmas dessert, there was a Christmas card.

But, the God never forgets me.
Mathieu, my superhero at Gunung Mulu Pinnacles on September 2013, sent me bunch of photos on the 23rd of Dec.
The superhero turns into Santa Clause this time.

Mathieu & Me

Catherine & Me

We took pictures in front of the brook.
This whole area was flooded at that time.
I still regret I didn’t take any pictures how the flood was.

Three months went by since then.
Time flies.
I feel at least one year passes away.

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2 réponses à “Steroid Pulse for IgA Nephropathy Treatment(Merry Christmas in Hospital), Japan, Dec 20-25, 2013

  1. I felt goosebumps reading those disease stuffs. 😦 Glad you stayed strong, came through at the end, and that you get to spend Christmas Day at least. I also felt your gratitude to your blessings deeply. And those pictures of you adventures… yey! 😀

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